30 ANNUAL CLINICAL EXPERIENCE OF THE REST REPRODUCTIVE FUNCTION OF PATIENTS WITH TUBAL PERITONEAL INFERTILITY

Abstract

The thirty-year experience of treating patients with tubal peritoneal infertility with different types of energy during laparoscopic intervention, various intraoperative prevention techniques for the development of adhesive process and rehabilitation of their generative function with the use of various complexes of physiotherapeutic and medical treatment in the postoperative period is presented.The aim of the study: comparison of the effectiveness of 2 methods of laparoscopic treatment and rehabilitation of the reproductive function of patients with tubalperitoneal infertility, which have been used during the last 30 years with the use of different types of energy, anti-spyware and various methods of rehabilitation in the postoperative period.Materials and methods of research: Clinical studies were conducted in 960 women, of which 480 women were the 1st clinical group, while they were treated with laparoscopic interventions using conventional mono and bipolar coagulation, intraoperative prevention of the development of the adhesion process and physiotherapy with intrapsychic trypsin. The 2nd clinical group consisted of 480 patients with tubal peritoneal infertility with laparoscopic treatment of which used radio waves, intraoperatively used anti-swab barrier, and in the postoperative period, physiotherapy was prescribed to patients, trypsin, intradermal lungidase, and a combination of streptokinase and streptodornase in the per rectum scheme. The control group consisted of 30 somatic and gynecologically healthy women.Results of clinical research and their discussion. In the laparoscopic treatment of patients of the 1st clinical group, the adhesive process I st. was found in 170 (35.4%), II st. - in 100 (20,8%), III st. - in 70 (14,6%), IV st. - in 140 (29.2%). In the laparoscopic treatment of patients of the 2 nd clinical group, the adhesive process I st. was found in 90 (18,75%), II st. - in 140 (29,15%), III st. - in 80 (16.7%), IV st. - in 170 (35.4%). When comparing interleukin indices in women of the 1st and 2nd clinical groups in the postoperative period, a greater decrease in the incidence of fibronectin, TFR-β, IL-1, and IL-6 in patients of the 2nd clinical group was revealed, indicating a higher anti-spill efficacy application of the developed complex of treatment and rehabilitation in patients of the 2 nd clinical group.Conclusions. The application of the proposed complex of treatment of patients with tubal peritoneal infertility using radio waves during laparoscopic interventions, intraperitoneal derivative of carbomethylcellulose and an early stage of rehabilitation complex allowed to increase the incidence of fallopian tubes up to 2.5 times, increase the incidence of uterine pregnancy by 1.6 times and reduce the risk of an ectopic pregnancy by 1.6 times.